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Haemorrhagic bronchial necrosis secondary to pill aspiration: case report A 31-year-old man developed haemorrhagic bronchial necrosis secondary to multimineral/multivitamin pill aspiration during treatment with multimineral/multivitamin [indication not stated]. The man presented for breathlessness on exertion and dry cough. Prior to the presentation, he had swallowed a multimineral/multivitamin soft gel capsule [dose not stated], which had several minerals including magnesium, molybdenum, calcium, iodine, zinc, selenium and copper in it. Immediately thereafter, he experienced cough and bronchospasm. However, the symptoms partially subsided prior to the presentation. At presentation, his oxygen saturation was normal along with stable vitals. Upon examinations, he was found to have normal chest X-ray, normal vocal cords and pharynx and nasal passages and normal blood tests. Bronchoscopy showed normal trachea and left bronchial tree. Severe oedematous and friable haemorrhagic areas were seen upon right side bronchus intermedius and middle and lower lobe bronchi examination. After washing bronchi with normal sodium chloride [saline], bronchial aspirate collected. Biopsy mucosa showed nonspecific inflammation and areas of necrosis with haemorrhages. Also, bronchial aspirate culture showed the growth of staphylococcus, [aetiology unknown], which were sensitive to common antibacterials [antibiotics]. The man received treatment with a course of unspecified steroids and amoxicillin/clavulanic acid. Eventually, his symptoms improved. A second bronchoscopy 18 days after the treatment showed significant clearing of the mucosal lesions in the right bronchial tree with almost normal looking mucosa. Author comment: "Multivitamin pill aspiration leading to hemorrhagic bronchial necrosis." Tamburrini M, et al. Multivitamin pill aspiration leading to hemorrhagic bronchial necrosis. Respiratory Medicine Case Reports 28: 14 Oct 2019. Available from: 803437625 URL: http://doi.org/10.1016/j.rmcr.2019.100944 - Italy

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Reactions 7 Dec 2019 No. 1782